[Mediastinoscopy in the evaluation of the operability of bronchial cancer].

Mediastinoscopy is an invasive technique used to explore the anterior and upper mediastinum. The axial mediastinum and its lymph nodes are explored through the cervical approach, and the pulmonary vessels and anterior mediastinal lymph nodes through the parasternal approach. Bronchial carcinomas which extend to the mediastinum, either via the lymphatic system or by contiguity, are of extremely severe prognosis. The advent of mediastinoscopy has considerably reduced the number of exploratory thoracotomies and therefore the operative mortality rate, while increasing the resectability rate to 95%. It has also narrowed the indications for surgery without decreasing the number of curative resections. In the hands of experienced operators, the technique has a low morbidity rate. CT examination is not as accurate as mediastinoscopy to evaluate the mediastinal extension of bronchial carcinomas, but it can help to lay down the indications for the invasive technique, thereby limiting its use to selected cases.